This undated electron microscope image made available by the U.S. National Institutes of Health in February 2020 shows the Novel Coronavirus SARS-CoV-2, orange, emerging from the surface of cells, green, cultured in the lab. Also known as 2019-nCoV, the virus causes COVID-19. (NIAID-RML via AP)

Hundreds of Indigenous health managers from across Canada are to meet online Wednesday to discuss how to prepare for the impact of the COVID-19 pandemic on their communities.

The Assembly of First Nations has already declared a state of emergency, asking for more resources to help remote, fly-in communities stay healthy.

"Whatever the needs are, they should be met," said AFN National Chief Perry Bellegarde.

"In a lot of instances, First Nations are the most vulnerable because of their isolation. They don't have access to the same level of health care that everybody else does."

Marion Crowe of the First Nations Health Managers Association expects about 500 people to join the meeting.

First Nations aren't counted separately in COVID-19 numbers, so there aren't any official cases, but Crowe said she's heard otherwise.

"There are a couple of instances that have been reported in our communities."

Rola Tfaili, an Indigenous Services Canada spokeswoman, confirmed Tuesday that the department has been notified of two cases on-reserve in Saskatchewan.

Crowe said First nations health managers have plenty of questions about the novel coronavirus, such as its impact on spiritual practices like sweats.

Many Indigenous people face challenges stemming from living conditions, Crowe said. It's tough to self-isolate in overcrowded houses and hand-washing is difficult without access to water.

Many northern nursing stations already face shortages of public health staples such as hand sanitizer and face masks, she added. Others are understaffed.

Bellegarde said transportation is also an issue.

Ice roads may have to be maintained longer than normal and the need to fly patients out may grow.

"National defence may have to be called upon to meet the need for transportation," he said.

Adding to concerns is that everything costs more in the North.

Bellegarde acknowledges that past experiences with government health officials haven't necessarily filled First Nations people with trust.

"That's always a challenge — First Nations people not trusting government. But in this instance, they should trust our own leaders when we say, 'Stay at home.'

"You don't want to be the one to bring this virus into your home community."

The federal government has pledged $305 million for Indigenous groups to fight COVID-19.

Bellegarde said Canada's 96 fly-in First Nations should receive special consideration for that money. He said he's content with assurances from Finance Minister Bill Morneau and Prime Minister Justin Trudeau that more could be available.

"We have assurances that these are scalable. If these resources aren't adequate, there shouldn't be any question about getting the resources in place to meet the need."

Bellegarde emphasized that First Nations leaders must be involved in planning any responses to COVID-19 in their communities.

Crowe said Indigenous public health officials have come a long way since the 2009 H1N1 epidemic.

"(H1N1) hit First Nations hard," she said. "There were a lot of conversations on putting planning into action."

Last year, her group published a tool kit to help plan for another such emergency and some are using it now.

All communities must be involved as Canada continues to fight against the growth of the pandemic, Crowe said.

"Everybody understands that they don't want to be left behind and be an afterthought."